DIMITRI'S SHOE SERVICELLC NPI 1619089992

NPI Information

  • NPI: 1619089992
  • Provider Name: DIMITRI'S SHOE SERVICE,LLC
  • Classification: Durable Medical Equipment & Medical Supplies - 332B00000X
  • Entity Type: Organization
  • Doing Business As: RED WING SHOES AND REPAIR
  • Address: 209 CONANT ST
    MAUMEE, OH
    ZIP 43537
  • Phone: (419) 893-8647

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NPI Details

DIMITRI'S SHOE SERVICE,LLC is a durable medical equipment medical supplies in Maumee, OH. The provider is a supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time. DIMITRI'S SHOE SERVICE,LLC NPI is 1619089992. The provider is registered as an organization entity type.
The provider Is Doing Business As Red Wing Shoes And Repair.

The provider's business location address is:

209 CONANT ST
MAUMEE, OH
ZIP 43537-355
Phone: (419) 893-8647
Fax: (419) 893-8694

The provider's authorized official is Maureen Georgevich .
The authorized official title is Assistant Manager and has the following contact phone number (419) 893-8647.

The enumeration date for this NPI number is 8/31/2006 and was last updated on 8/22/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1332B00000XDurable Medical Equipment & Medical SuppliesOHIOYes

What is NPI?

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This page was last updated on: 11/21/2025

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